Individual
DR. LISA S RAVENEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MHS
Contact information
Practice address
1130 E BUTLER RD, GREENVILLE, SC 29607-5908
(864) 987-9700
Mailing address
1130 E BUTLER RD, GREENVILLE, SC 29607-5908
(864) 987-9700
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3710
SC
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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